Cranial Indicators Identified for Peak Incidence of Otitis Media.

Acute otitis media (AOM) is one of the most common pediatric conditions worldwide. Peak age of occurrence for AOM has been identified within the first postnatal year and it remains frequent until approximately six postnatal years. Morphological differences between adults and infants in the cartilaginous Eustachian tube (CET) and associated structures may be responsible for development of this disease yet few have investigated normal growth trajectories.

Balloon dilation of the eustachian tube is indeed a "gizmo" until future research proves safety and efficacy.

In the April 2014 issue of this journal, Richard M. Rosenfeld, MD, MPH, wrote an editorial in which he recommends distinguishing "fanciful gizmos from truly useful technology," provides 5 criteria to evaluate a gizmo, and includes as one of the current ones balloons to "open clogged ears." The implication is that balloon dilation for suspected eustachian tube dysfunction-middle ear disease is an unproven procedure.

Panel 2: Eustachian tube, middle ear, and mastoid--anatomy, physiology, pathophysiology, and pathogenesis.

Objective: This report reviews the literature to identify the advances in our understanding of the middle ear (ME)-Eustachian tube (ET) system during the past 4 years and, on that basis, to determine whether the short-term goals elaborated in the last report were achieved and propose updated goals to guide future otitis media (OM) research.

Data Sources: Databases searched included PubMed, Web of Science (1945-present), Medline (1950 to present), Biosis Previews (1969-present), and the Zoological Record (1978 to present). The initial literature search covered the time interval from January 2007 to June 2011, with a supplementary search completed in February 2012.

Consequences of evolution: is rhinosinusitis, like otitis media, a unique disease of humans?

We hypothesize that if otitis media is most likely primarily a human disease due to consequences of evolution, rhinosinusitis may also be limited to humans for similar reasons. If otitis media, with its associated hearing loss, occurred in animals in the wild, they probably would have been culled out by predation. Similarly, if rhinosinusitis occurred regularly in animals, they likely would have suffered from severely decreased olfactory abilities, crucial for predator avoidance, and presumably would likewise have been selected against evolutionarily.

Trajectories of BMI from early childhood through early adolescence: SES and psychosocial predictors.

Objectives: This study examined the ways in which body mass index (BMI) percentile - an identified risk factor for overweight and cardiovascular disease in adulthood - develops from birth through early adolescence. In addition, we examined whether psychosocial factors, such as parenting style and maternal depression, mediated the link between socio-economic status (SES) and BMI growth. Design.

Persistent alternobaric vertigo at ground level.

We recently encountered a 15-year-old female with bilateral tympanostomy tubes who manifested persistent severe vertigo, at ground level, secondary to a unilateral middle-ear pressure of +200 mm H(2)O elicited by an obstructed tympanostomy tube in the presence of chronic nasal obstruction. We believe this is a previously unreported scenario in which closed-nose swallowing insufflated air into her middle ears, resulting in sustained positive middle-ear pressure in the ear with the obstructed tube. Swallowing, when the nose is obstructed, can result in abnormal negative or positive pressures in the middle ear, which has been termed the Toynbee phenomenon.

Human evolutionary history: consequences for the pathogenesis of otitis media.

The pathogenesis of otitis media is multifactorial, but the role of evolution on its development has not been addressed. We posit that the high prevalence of middle-ear disease is most likely restricted to humans, in contrast to other wild species, because the associated hearing loss would have reduced the fitness of affected individuals as a result of predation. We present here the possible consequences of two human adaptations that may have resulted in ubiquitous otitis media: the interaction of bipedalism and increased brain size, and the loss of facial prognathism resulting from speech or cooking.

Adenoidectomy for otitis media with effusion in 2-3-year-old children.

Objective: To compare the efficacy of three surgical treatment combinations - myringotomy and tympanostomy tube insertion (M&T), adenoidectomy with M&T (A-M&T), and adenoidectomy with myringotomy (A-M) - in reducing middle-ear disease in young children with chronic OME.

Methods: Children 24-47 months of age, with a history of bilateral middle-ear effusion (MEE) for at least 3 months, unilateral for 6 months or longer or unilateral for 3 months after extrusion of a tympanostomy tube, unresponsive to recent antibiotic, were randomly assigned to either M&T, A-M&T, or A-M. Treatment assignment was stratified by age (24-35 months, 36-47 months), nasal obstruction (no, yes) and previous history of M&T (no, yes).

Galapagos: Darwin, evolution, and ENT.

This year is especially important in the history of the theory of evolution; 2009 is the bicentennial anniversary of the birth of Charles Darwin and the sesquicentennial anniversary of his publication, The Origin of Species. Darwin visited the Galapagos Islands as a young man, which greatly influenced his thinking. My son Jim and I had the good fortune to visit these islands in January 2009 and see firsthand what led Darwin to arrive at his monumental insights into the origins of life on this planet.

Impact of evolution on the eustachian tube.

I posit that humans appear to be the only species that develops otitis media. If animals in the wild had developed middle-ear disease to any significant degree, they would have been selected out during evolution because they would not have survived their predators given the associated hearing loss. Why do humans have otitis media? Evolution has had a significant impact.

Humans are born too soon: impact on pediatric otolaryngology.

Humans are born 12 months too early. Gestation should be 21 months. Humans evolved to become the pre-eminent animal in the world, but our big brain, bipedalism, and small female pelvic outlet have caused us to pay the price of being born too soon with all of its disadvantages.

Studies in otitis media: Children's Hospital of Pittsburgh-University of Pittsburgh progress report--2004.

Objectives/hypothesis: The present Progress Report has summarized the key otitis media clinical trials and laboratory studies conducted since 1969 by investigators at the Children's Hospital of Pittsburgh-University of Pittsburgh (Pittsburgh, PA).

Study Design: Review.

Methods: Included in the discussion are the following: 1) studies of the epidemiology and risk factors; 2) anatomy and pathology of the eustachian tube-middle ear from human temporal bone histopathological specimens; 3) physiology and pathophysiology of the eustachian tube-middle ear in humans and animal models; 4) pathogenesis; 5) otitis media in special populations (e.

The genetic component of middle ear disease in the first 5 years of life.

Objective: To determine the genetic component of time with middle ear effusion (MEE) and episodes of MEE and acute otitis media.

Design: Prospective twin/triplet cohort.

Setting: Research center at a tertiary pediatric hospital.

Evaluation of bizarre-idiosyncratic thinking scale as a measure of thought disorder in children and adolescents with severe psychiatric disorders.

To investigate the prevalence of thought disorder and the possible appropriateness of the Bizarre-Idiosyncratic Thinking Scale for children and adolescents with severe psychiatric disorders, 96 child and adolescent inpatients and day hospital patients, ages 6 to 18 years, at a state psychiatric hospital were rated by review of retrospective records using Marengo and Harrow's 1986 Evaluation of Bizarre-Idiosyncratic Thinking Scale for the presence of thought disorder in the Thematic Apperception Test and Rorschach Inkblot Test responses. Although the Evaluation of Bizarre-Idiosyncratic Thinking Scale had not been previously used with children and adolescents, the analysis suggested possible indications of thought disorder in several diagnostic groups. No significant differences were found on the Rorschach between patients with Schizophrenia and Psychosis, Not Otherwise Specified and those with Attention Deficit Hyperactivity Disorder, Major Depression, and Conduct Disorder.

Eustachian tube function in older children and adults with persistent otitis media.

Objective: Otitis media (OM) is most common in infants and young children. Despite a dramatic reduction in its incidence after the age of six, the disease still occurs in older children, adolescents, and may even persist into adulthood. The goal of this study was to identify characteristics of eustachian tube (ET) function in an older population which may underlie their persistent OM.

Outcome of hearing and vertigo after surgery for congenital perilymphatic fistula in children.

Purpose: To determine if surgery to repair a perilymphatic fistula (PLF) has any significant morbidity and to determine the outcome of the surgery in regards to hearing and vertiginous symptoms.

Materials And Methods: A retrospective study was performed with all patients undergoing PLF repair at a tertiary medical center. Each patient was assessed for comparison of their pre- and postoperative hearing levels, vertiginous complaints, and recurrences.

Outcome in pediatric tracheotomy.

Objective: To investigate the outcome and related factors in pediatric tracheotomy.

Design: Retrospective chart review.

Setting: Tertiary pediatric academic hospital setting.